Debit Mandate Form NACH
Debit Mandate Form NACH
Debit Mandate Form NACH
UMRN F O R O F F I C E U S E O N L Y Date D D M M Y Y Y Y
CREATE ü
MODIFY Sponsor Bank Code For office use only Utility Code For office use only
CANCEL
I/We, hereby authorize LIC Mutual Fund To debit (Please ü) SB / CA / CC / SBNRE / SB-NRO / Other
an amount of Rupees `
FREQUENCY Monthly Quarterly Half Yearly Yearly ü As & when presented DEBIT TYPE Fixed Amount ü Maximum Amount
Reference 2 Email ID
I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the Bank
PERIOD
From D D M M Y Y Y Y Signature Primary Account holder Signature Primary Account holder Signature Primary Account holder
To
Or ü Until cancelled
Name as in bank records Name as in bank records Name as in bank records
1. 2. 3.
• This is to confirm that the declaration has been carefully read, understood & made by me/us. I am authorizing the user entity/Corporate to debit my account, based on the instruction as agreed and signed by me.
• I have understood that I am authorized to cancel/amend this mandate by appropriately communicating the cancellation/amendment request to the User entity/Corporate of the bank where I have authorized the debit.
an amount of Rupees `
FREQUENCY Monthly Quarterly Half Yearly Yearly ü As & when presented DEBIT TYPE Fixed Amount ü Maximum Amount
Reference 2 Email ID
I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the Bank
PERIOD
From D D M M Y Y Y Y Signature Primary Account holder Signature Primary Account holder Signature Primary Account holder
To
Or ü Until cancelled
Name as in bank records Name as in bank records Name as in bank records
1. 2. 3.
• This is to confirm that the declaration has been carefully read, understood & made by me/us. I am authorizing the user entity/Corporate to debit my account, based on the instruction as agreed and signed by me.
• I have understood that I am authorized to cancel/amend this mandate by appropriately communicating the cancellation/amendment request to the User entity/Corporate of the bank where I have authorized the debit.
General Instruction for filling up NACH Mandate.
Mandatory fields for filling NACH mandate. In case any of these fields are not filled, mandate will be rejected.
• Account Type
• Bank A/c. number
• Bank Name
• IFSC code or MICR code (As per the Cheque / Pass book)
• Amount in Words (Maximum amount)
• Amount in Figures (Maximum amount)
• Period Start Date and End Date or until cancelled
• Account Holder Signature
• Account Holder Name as per Bank Record.
• Do not write any extra details on the mandate.
• Investor can change his bank mandate by sending the new mandate with option selected and 'modify mandate'.
• Please attach a copy of canceled cheque along with mandate.
• AMC do not charge investor for enrolling SIP however Bank may levy charges to investor's bank account for NACH registration